Provider Demographics
NPI:1023686300
Name:PEELMAN, AMY RENEA (FNP-BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RENEA
Last Name:PEELMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4274 CHAMPDALE LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-6231
Mailing Address - Country:US
Mailing Address - Phone:513-802-0507
Mailing Address - Fax:
Practice Address - Street 1:MATRIX MEDICAL NETWORK
Practice Address - Street 2:9201 E. MOUNTAIN VIEW ROAD, STE 220
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:877-564-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2020168284207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine